OBJECTIVES : Guselkumab and tildrakizumab are IL-23-inhibitors which have not been compared in head to head studies. Published network-meta-analysis only show comparisons up to week 16 due to a lack of a common comparator arm beyond that timepoint. The objective of this study was to compare PASI response rates between the two treatments beyond the induction phase using data from Phase 3 randomized control trials, adjusting for differences in study populations.

METHODS : An unanchored matching-adjusted indirect comparison (MAIC) was conducted using individual patient data (IPD) for guselkumab (28-week data from VOYAGE 1 and VOYAGE 2) and summary-level data for tildrakizumab standard doses 100 and 200mg (pooled 28-week data from re-SURFACE-1 and re-SURFACE-2). Matching was based upon propensity score weighting methods where guselkumab patients were re-weighted so that summary patient baseline characteristics matched those in the pooled tildrakizumab arm of re-SURFACE-1 and re-SURFACE-2. The primary outcome assessed was PASI 90 response, in line with the primary outcome of the VOYAGE 1 and 2 trials. In addition, PASI 75/100 responses were assessed. Non-responder imputation methodology was used as the primary approach for handling missing data resulting from patient discontinuation. Odds ratios (OR) with 95% confidence intervals (CI) were calculated for reported timepoints.

RESULTS : At weeks 12 and 28, more patients in the guselkumab arm (57.8% at week 12 and 77.0% at week 28) achieved a PASI 90 response vs tildrakizumab 100mg (36.7% at week 12, OR 2.365, 95% CI 1.845; 3.030, p<.0001 and 51.9 % at week 28, OR 3.097, 95% CI 2.371; 4.047, p<.0001). Similar results were seen for tildrakizumab 200mg. Guselkumab also showed better results in PASI 75/100.

CONCLUSIONS : Results of this MAIC suggest that PASI response rates are higher for guselkumab compared to tildrakizumab at weeks 12 and 28.